The present invention is generally directed to medical devices. More particularly, the present invention is directed to an artificial retina medical device and method to more efficiently stimulate electrically and with higher resolution, neuroretinal cells in partially damaged retinas to produce artificial vision. The invention provides improved efficiency and resolution of the device by using transretinal electrical current stimulation provided by stimulation and ground return electrodes that are disposed on opposite sides of the neuroretina.
A variety of retina diseases cause vision loss or blindness by destruction of the vascular layers of the eye that include the choroid and choriocapillaris, and the outer retinal layers that include Bruch""s membrane and retinal pigment epithelium. Loss of these layers is often accompanied by degeneration of the outer portion of the neuroretina, typically the photo receptor layer. Variable sparing may occur of the remaining neuroretina composed of the outer nuclear, outer plexiform, inner nuclear, inner plexiform, ganglion cell and nerve fiber layers.
Known prior efforts to produce vision by retinal electrical stimulation used arrays of stimulating electrodes with their ground return electrode or electrodes disposed either entirely on the epiretinal or the subretinal side of the neuroretina. Placement of stimulating and ground return electrodes together in this fashion resulted in inefficient stimulation of the neuroretina because the electrical field was not forced directly through the neuroretina. Resolution was also degraded because of diffuse spreading of each stimulating electrode""s electrical field.
The artificial retina device of this invention is preferably composed of two basic units, the stimulating electrode unit and the ground return electrode unit. In one embodiment, the two units are physically and electrically continuous, or physically and electrically connected by an insulated tail-like conductor that in some embodiments supports, positions, and aligns the two units on opposite sides of the neuroretina relative to each other. The stimulating electrode unit is, for example, a silicon disk 3 mm in diameter and 25 microns thick, and is comprised of separated stimulating microelectrode subunits. Preferably, the stimulating electrode unit has a ground return electrode unit extending from one edge, comprised of a silicon tail with an insulated conductor leading to the ground return electrode at its tip. The stimulating microelectrode subunits of the stimulating electrode units deliver current generated by one or more microphotodiodes connected, for example, in series and fabricated within the subunit. The preferred number of microphotodiodes per subunit is one.
In other embodiments, each microelectrode subunit is preferably fabricated on a node of a disk-shaped silicon web, the subunits separated by open areas of the web. The open areas of the web allow nourishment and oxygen from the outer retinal circulation to diffuse into the neuroretina.
In the preferred embodiment, on the backside of the stimulating electrode unit, i.e. the side opposite the incident light side, an insulated common conductor is constructed and arranged to electrically ground the microelectrode subunits. The common ground conductor preferably continues along the length of the ground return electrode unit and terminates in an exposed ground return electrode at or near the tip of the ground return electrode unit, and disposed in the vitreous cavity. The exposed ground return electrode tip in the vitreous cavity allows the electrical field generated by the microelectrode subunits in the subretinal space to transretinally stimulate the neuroretina.
In a second embodiment, an additional tail with an embedded conductor and an electrode tip is connected to the ground electrode tip of the ground electrode unit to extend the location of the ground electrode further into the vitreous cavity.
In a third embodiment, the conductor of the ground electrode unit is electrically connected with an additional bias photodiode or photodiodes to increase the voltage and current generated by the device. In this latter case, the ground electrode of the device is preferably disposed on the additional bias photodiode or photodiodes disposed in the vitreous cavity.
In a fourth embodiment, the bias photodiode or photodiodes are placed in the lens capsular bag of the eye after surgical removal of the lens nucleus and cortical material.